Robin Bartlett

I have always felt different: the experience of attention-deficit/hyperactivity disorder in childhood.

Childhood attention-deficit/hyperactivity disorder (ADHD) is one of the most important psychiatric problems of our time. This study examined the experience of childhood ADHD within the contexts that are most significant to this age group--home, school, and friendships. The sample included 16 college-enrolled young adults (ages 18-25) with a self-reported history of ADHD. Participants revealed feelings of difference, misunderstanding, and struggle in all areas of their lives (home, school, and friendships). Nurses can use these findings to improve the care and long-term outcomes of children diagnosed with ADHD.

Recruitment and Retention of African American and Hispanic Girls and Women in Research

Recruiting women and girls into research studies, especially minority women, continues to be a major challenge that impacts health policy and delivery systems. This article discusses various strategies to recruit and retain African American and Hispanic girls and women in studies. Strategies for successful recruitment focus on trust, familiarity and visibility, racial and ethnic similarities, environmental context, and convenience. Retention strategies include issues of transportation, language, literacy, cultural appropriateness, safety, flexibility, incentives, communication, and veracity. All strategies assist in meeting the challenge of engaging minority women in research to decrease health disparities.

Interdisciplinary Collaboration: The Need to Revisit

Given the complexity of the health care system and the prevalence of acute and chronic mental illnesses, multi-system interventions from an interdisciplinary team of health care providers are necessary to address the needs of individuals in psychiatric and mental health treatment venues. Despite claims that interdisciplinary practice is the norm, in reality it is difficult to accomplish (18). Students must be taught the principles and elements of this way of providing care in order to succeed. This paper describes strategies for educating undergraduate nursing students to engage in interdisciplinary collaborative practice. Two case studies are used to illustrate how teaching collaborative skills can be integrated into a psychiatric undergraduate nursing course.

Feasibility and Initial Efficacy Testing of an HIV Prevention Intervention for Black Adolescent Girls

HIV is disproportionately prevalent among Blacks. Black women most often contract HIV from having risky sex, and adolescence is a time when risky sex behaviors peak. This study tested the feasibility and initial efficacy of an intervention designed to help Black adolescent girls avoid risky sex behaviors. The intervention included group education for girls followed by a service learning opportunity in which the girls practiced the assertiveness and communication skills they had learned in the education sessions, and individual education for the girls’ mothers. The intervention was guided by a risk and protective factors framework and by the goal of promoting racial/ethnic pride in the girls. We determined that the intervention was feasible. Schools allowed recruitment of potential participants and the use of their facilities for meeting with the girls. We encountered little participant dropout from the study, and the intervention was highly regarded by the girls who participated and their mothers. We found improvements in aspects of the girls’ relationships with their mothers, their sexual assertiveness, and their self-efficacy to use condoms.

IMPLEMENTATION AND TESTING of the OPT MODEL as a Teaching Strategy in an Undergraduate Psychiatric Nursing Course

ABSTRACT Teaching undergraduate nursing students to think critically and reason clinically is a challenge for nurse educators, yet these skills are essential for the professional nurse.The Outcome‐Present State‐Test (OPT) Model of Reflective Clinical Reasoning (Pesut & Herman, 1999) provides a framework for teaching clinical reasoning skills to nursing students.This article describes how the model can be used in clinical teaching of undergraduate students in psychiatric and mental health settings and presents some findings from an evaluation of the model. Strategies employed in the model implementation are described, along with the benefits and limitations of this teaching method in a psychiatric clinical setting.

PSYCHIATRIC NURSING CASE MANAGEMENT: PAST, PRESENT, AND FUTURE

This literature review examines the evolution of psychiatric nursing case management in the United States. Various models, both inpatient and outpatient, are described, along with the roles of the case manager in each setting. The development of clinical pathways to monitor and document outcomes in acute settings is examined, along with the difficulties in adapting them specifically to psychiatric nursing case management. The types of data collected and the use of outcomes to support programs for the mentally ill are reviewed. Finally, recommendations for psychiatric nursing case management are made to provide guidelines for the future.

Trajectories of risk behaviors across adolescence and young adulthood: The role of race and ethnicity.

INTRODUCTION Despite important advances of longitudinal research in substance use behaviors, most studies stratify analyses by gender or race, which limits the ability to directly compare the likelihood of a particular developmental pathway across demographic groups. Thus, there is critical need for well-designed research to examine the associations of race/ethnicity with developmental trajectories of substance use behaviors across adolescence through adulthood. METHODS Using an accelerated longitudinal design, we examined behaviors across ages 12-31 from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health. We performed growth mixture modeling, resulting in estimated trajectories over time. Next, we assessed the association between race/ethnicity and trajectory membership using multinomial logistic regression. RESULTS Five trajectories resulted for marijuana use, four for cigarette smoking, three for smokeless tobacco use and number of days drunk, and two trajectories for heavy episodic drinking. Controlling for gender and family socioeconomic status, African Americans and Hispanics were less likely than non-Hispanic Whites to use cigarettes or smokeless tobacco early or to use alcohol heavily. CONCLUSIONS Substance use behavior development follows different pathways for US adolescents and young adults, with some individuals experimenting earlier in adolescence and others beginning to use later in adolescence or in early adulthood. We extend developmental knowledge about these behaviors by demonstrating that the patterns of behavior vary by race/ethnicity; members of lower-risk trajectories (those involving later or no initiation of substance use) are more likely to be African American or Hispanic than to be non-Hispanic White.

Schools as Sites for Recruiting Participants and Implementing Research

ABSTRACT Schools can be a valuable resource for recruitment of participants for research involving children, adolescents, and parents. Awareness of the benefits and challenges of working with schools can assist researchers in developing effective school partnerships. This article discusses the advantages of conducting research within the school system as well as the challenges that may also arise. Such challenges include developing key contacts, building relationships, logistical arrangements, and facilitating trust in the research topic and team. Suggestions for strategies to forge successful collaborative relationships with schools are provided.

A Common Language Is So Basic

It seems obvious that a person seeking care of any type should have a caregiver who speaks that persons language. Unfortunately, that does not always happen in the mono-lingual US, where a sizable minority, more than 8.5% of those aged 5 years and older, speak English “less than very well” (U.S. Census Bureau, 2009). In eight states, 10–20% of the population fall into this category, making it even more challenging for them to find a caregiver with whom they can communicate. Nursing care, especially that associated with the provision of mental health services, centers on conversation. Language barriers can compromise such care and pose a risk to patient health.

ACES: A Program to Improve Asthma Outcomes in a High-Morbidity Pediatric Population

The goal of this project was to determine if a nurse practitioner (NP) designed and managed primary care based asthma quality improvement (QI) program titled Asthma Control and Elimination of Symptoms (ACES) could improve asthma outcomes in a high-morbidity pediatric population. A convenience sample of 31 children age 2 to 17 years with persistent asthma were recruited from a private practice in a rural community to participate in this prospective study with 3 months of follow-up. The primary outcome measures were symptom improvement and use of symptom prevention medication. The secondary outcome measures were reduced ED visits and hospitalizations. Participants in the ACES program had significant improvement in daytime asthma symptoms, nighttime asthma symptoms, use of rescue medication, activity tolerance, missed school days, attacks lasting longer than 24 hr, and use of symptom prevention medication. There was a decrease in ED visits and no change in rate of hospitalizations. One hundred percent of participants completed the program and the QI project improved health outcomes of all children in the program.